510(K) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE

510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY ASSAY ONLY TEMPLATE

A. 510(k) Number:

k181945

B. Purpose for Submission:

Modification of a previously cleared device to add Imipramine and Buprenorphine to the test panel.

C. Measurand:

Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy (MDMA), Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, Marijuana, Imipramine, Buprenorphine

D. Type of Test:

Qualitative lateral flow immunoassay

E. Applicant:

Phamatech, Inc.

F. Proprietary and Established Names:

QuickScreen Pro Multi Drug Screening Test, Model 9395Z

G. Regulatory Information:

1. Regulation section:

Product Code Regulation Number Regulation Description DKZ 862.3100 Amphetamine test system DIS 862.3150 Barbiturate test system JXM 862.3170 Benzodiazepine test system DIO 862.3250 Cocaine and cocaine metabolite test system DJC 862.3610 Methamphetamine test system DJR 862.3620 Methadone test system DJG 862.3650 Opiate test system

1 Product Code Regulation Number Regulation Description LCM Unclassified Phencyclidine LDJ 862.3870 Cannabinoid test system LFG 862.3910 Tricyclic antidepressant drugs test system

2. Classification:

Class II

4. Panel:

Toxicology

H. Intended Use:

1. Intended use(s):

See indications for use below.

2. Indication(s) for use: The QuickScreen™ Pro Multi Drug Screening Test Model 9395Z is a screening test for the qualitative detection of amphetamines, barbiturates, benzodiazepines, cocaine, ecstasy (MDMA), methadone, methamphetamine, opiates, oxycodone, phencyclidine, marijuana, tricyclic antidepressants (Imipramine) and buprenorphine in urine at the cut-off concentrations listed below. Test for barbiturates, benzodiazepine, oxycodone, buprenorphine and tricyclic antidepressants (Imipramine) cannot distinguish between abused drugs and certain prescription medications. The test is intended for professional use only.

Cut-off Analyte Abbreviation Concentration (ng/ml) Amphetamines AMP 1000 Barbiturates BAR 200 Benzodiazepines BZD 200 Cocaine COC 300 Ecstasy MDMA 500 Methadone MTD 300 Methamphetamine MET 500 Opiates OPI 300 Oxycodone OXY 100 Phencyclidine PCP 25 Marijuana THC 50

2 Cut-off Analyte Abbreviation Concentration (ng/ml) Tricyclic Antidepressants TCA 1000 (Imipramine) (Imipramine) Buprenorphine BUP 10

This test provides only a preliminary test result. A more specific alternate testing method must be used in order to obtain a confirmed analytical result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Other confirmation methods are available. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are observed.

3. Special conditions for use statement(s):

For prescription use only

4. Special instrument requirements:

Not applicable. These devices are single use and disposable.

I. Device Description:

The QuickScreen™ Pro Multi Drug Screening Test, Model 9395Z is a competitive immunoassay that is used to screen for the presence of the following drugs of abuse in urine: Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, Marijuana, Imipramine, and Buprenorphine. The device is single-use utilizing a cup format. Each kit consists of the following materials:

· Twelve separate test strips for the 13 target drugs. Each test strip device includes monoclonal anti-drug antibody/colloidal gold conjugate specific to each drug coated in the sample path, drug derivative/protein conjugate immobilized as a line in the Test Region (T), and goat anti-rabbit antibody immobilized as a line in the Control Region (C). · Instructional insert · Urine sample collection cup · Built-in timer to identify when test test results should be read

J. Substantial Equivalence Information:

1. Predicate device name(s): At Home Drug Test 12: Model 9308Z

3 2. Predicate 510(k) number(s): k070009

3. Comparison with predicate:

Similarities Item QuickScreen™ Pro Multi At Home Drug Test 12: Drug Screening Test, Model Model 9308Z (k070009) 9395Z Predicate Device Indications for use The QuickScreen™ Pro Multi Same Drug Screening Test Model 9395Z is an screening test for the qualitative detection of amphetamines, barbiturates, benzodiazepines, cocaine, ecstasy, methadone, methamphetamine, opiates, oxycodone, phencyclidine, marijuana, tricyclic antidepressants (Imipramine) and buprenorphine in urine at the cut-off concentrations listed. Methodology Lateral flow immunoassay Same based on the principle of antigen and antibody immunochemistry Results Qualitative Same Analyte Cut-off Amphetamines (AMP): Same for shared analytes 1000 ng/ml Barbiturates (BAR): 200 ng/ml Benzodiazepines: (BZD): 200 ng/ml Cocaine (COC): 300 ng/ml Ecstasy (MDMA): 500 ng/ml Methadone (MTD): 300 ng/ml Methamphetamine (MET): 500 ng/ml Opiates (OPI): 300 ng/ml Oxycodone (OXY): 100 ng/ml Phencyclidine (PCP): 25

4 Similarities Item QuickScreen™ Pro Multi At Home Drug Test 12: Drug Screening Test, Model Model 9308Z (k070009) 9395Z Predicate Device ng/ml Marijuana (THC): 50 ng/ml Tricyclic Antidepressants (TCA): 1000 ng/ml Buprenorphine (BUP): 10 ng/ml Configuration Cup Same Specimen Type Urine Same Use Single-use Same

Differences Item QuickScreen™ Pro Multi Drug At Home Drug Test 12: Screening Test Model 9395Z Model 9308Z (k070009) Predicate Device Use Setting Prescription OTC

K. Standard/Guidance Document Referenced (if applicable):

None referenced.

L. Test Principle:

TheQuickScreen™ Pro Multi Drug Screening Test, Model 9395Z device employs lateral flow immunochromatographic technology, which involves the recognition and formation of a specific antibody/target drug complex. Drug in the sample and drug-labeled conjugate compete for antibody binding sites. During testing, a urine specimen migrates upward by capillary action. If target drugs present in the urine specimen are below the cut-off concentration, it will not saturate the binding sites of its specific monoclonal mouse antibody coated on the particles. The antibody-coated particles will then be captured by immobilized drug-conjugate and a visible colored line will show up in the test line region (T). The colored line will not form in the test line region if the target drug level exceeds its cutoff- concentration because it will saturate all the binding sites of the antibody coated on the particles. The control line (C) serves as an internal quality control to ensure proper sample volume has been added to the test and that the sample has correctly migrated up the test strip.

5 M. Performance Characteristics (if/when applicable):

1. Analytical performance:

a. Precision/Reproducibility:

A precision/reproducibility study was performed using the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device at three separate point of care (POC) sites. Multiple replicates of each of the nine drug concentrations (prepared by spiking negative urine samples with buprenorphine or TCA (Imipramine)) was assayed over a minimum of 5 days. The tests were done in accordance with the package insert instructions using one lot of the device, and a summary of the results are provided in the table below. Precision performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

Test Results for BUP Level BUP Conc. (ng/ml) % of cutoff Result % Correct (Neg/Pos) 1 0.00 0 80/0 100% 2 2.58 - 75% 80/0 100% 3 5.62 - 50% 80/0 100% 4 7.13 - 25% 80/0 100% 5 10.42 cutoff 0/80 100% 6 12.27 + 25% 0/80 100% 7 16.83 + 50% 0/80 100% 8 17.69 + 75% 0/80 100% 9 20.43 +100% 0/80 100%

Test Results for TCA (Imipramine) Level TCA Conc. (ng/ml) % of cutoff Result % Correct (Neg/Pos) 1 0.00 0 80/0 100% 2 249.53 - 75% 80/0 100% 3 547.65 - 50% 80/0 100% 4 767.56 - 25% 80/0 100% 5 1026.32 cutoff 0/80 100% 6 1267.91 + 25% 0/80 100% 7 1589.23 + 50% 0/80 100% 8 1789.60 + 75% 0/80 100% 9 2089.3 +100% 0/80 100%

b. Linearity/assay reportable range:

Not applicable.

6 c. Traceability, Stability, Expected values (controls, calibrators, or methods):

There are no external controls supplied with the device.

Real time stability tests were conducted over 24 months. Protocol and acceptance criteria were found to be acceptable. The manufacturer claims that the devices are stable for 22 months. d. Detection limit:

See precision data in Section M.1.a., above, for assay performance around the claimed cutoff concentrations. e. Analytical specificity:

Cross-reactivity: Cross-reactivity studies for BUP and Imipramine were conducted for the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device (BUP and TCA) by testing structurally similar compounds. The compounds in the below table were tested for cross reactivity, and the lowest concentration causing a positive result was determined to calculate the percentage of cross-reactivity. Cross-reactivity performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

BUP Cross Reactivity Compound Lowest conc. resulting in % cross reactivity positive result Norbuprenorphine 20 ng/ml 50% Morphine N/A <0.01% Buprenorphine-3-ß-D- 10 µg/ml 0.1% Glucuronide Norbuprenorphine-3-ß-D- 20 µg/ml 0.2% Glucuronide Oxymorphone N/A <0.01% Hydromorphone N/A <0.01% TCA Cross Reactivity Compound Lowest conc. resulting % cross reactivity in positive result Amitriptyline 250 ng/ml 400% N-Desmethylclomipramine 100 mg/ml 1% N-Desmethyltrimipramine- 100 mg/ml 1% maleate Cyclobenzaprine 500 ng/ml 200% Cyproheptadine 100 mg/ml 1% Desiprimine 250 ng/ml 400% Doxepin 100 ng/ml 1000%

7 Imipramine 1000 ng/ml 100% Maprotiline N/A <0.01% Nordoxepin N/A <0.01% Nortriptyline 100 mg/dl 1% Promazine N/A <0.01% Promethazine N/A <0.01% Protryptyline 100 mg/dl 1%

Interference: The following compounds did not show interference with the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device (for BUP and Imipramine) when tested at BUP and Imipramine concentration of 50% and 150% of cut-off values. Interference performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

Compound Conc. Compund Conc. tested tested (µg/ml) (µg/ml) 6-Acetylcodeine 100 Ketamine 100 6-Acetylmorphine 100 Levallorphan Tartrate 100 Acetaminophen 100 Lidocaine 100 Acetaminophen 500 Lormetazepam 100 Acetylsalicylic Acid 500 Lysergic Acid Diethylamide 100 (Aspiring) Acetylsalicylic Acid 1000 MDEA 100 (Aspiring) Alprazolam 100 d-Methamphetamine 100 α-Hydroxyaprazolam 100 I-Methamphetamine 100 Aminogluthethimide 100 Metanphrine 100 Amobarbital 100 Methaqualone 100 S(+) Amphetamine 100 Metoprolol 100 Aprobarbital 100 Methylenedioxyamphetamine 100 (MDA) Apromorphine 100 Methylphenidate 100 Ascorbic Acid 10,000 Methylphenidate 500 Ascorbic Acid 15,000 Methylphenidate 1000 Ampicillin 100 Metoclopramide 150 Amoxicillin 100 Metoclopramide 300 Barbituric Acid 100 Morphine 100 Benzoylecgonine 100 Morphine-3-β-D Glucuronide 100 Oxalic Acid 100 Nafcillin 100 Benzphetamine 100 Nalbuphine 100 Benztropine Methane 100 Naloxone 100 Sulfonate Bilirubin 100 Naltrexone 100

8 Compound Conc. Compund Conc. tested tested (µg/ml) (µg/ml) Bromazepam 100 Naphazoline 100 Brompheniramine 100 Netilmicin 100 Butabarbital 100 Nifedipine 100 Butabital 100 Nitrazepam 100 Butalbital 100 Norbuprenorphine 100 N-Desmethylimipramine 100 Norcodeine 100 Caffeine 100 Nordoxepin 100 Caffeine 500 Normorphine 100 Cannabidiol 100 Noroxymorphone 100 Cannabidiol 100 Nylidren 100 Cannabinol Delta 9 5 Oxazepam 100 Chlordiazepoxide 100 Oxycodone 100 Chlorpropamide 100 Oxymetazoline 100 Chloroprothixene 100 Penicillin-G 100 Chloroquine 100 Pentazocine 100 Chlorpheniramine 100 Pentobarbital 100 Clamastine 100 Phencyclidine 100 Clorimpramine 100 Phenylephrine 100 Clonazepam 100 Phenylbutazone 100 Codeine 100 Phenylcyclopropylamine HCl 100 Cotinine 100 Phenylethylamine 100 Creatinine 2500 Terbutaline 100 Creatinine 5000 Phenytoin 100 Cyclizine 100 Prazepam 100 Cyclosporin 100 Prednisolone 100 Desalkylflurazepam 100 Primadone 100 Dextromethorphan 100 Procainamide 100 Diazepam 100 Promethazine 100 Dihydrocodeine 100 Promazine 100 Dipehnylhydantoin 100 Proproxyphine 100 Dipehnylhydantoin 2500 S, S (+)-Pseudoephedrine 100 Dipehnylhydantoin 5000 Pyrilamine 100 Doxylamine 100 Quinidine 100 Ecgonine 100 Ranitidine 100 Ecgonine Methyl Ester 100 Salicylic Acid 100 Efavirenz 100 Scopolamine 100 Ephedrine 100 Secobarbital 100 Epinephrine 100 Temazepam 100 Erythromycin 100 Thioridazine 250 Ethanol 10,000 Thioridazine 500 Ethanol 25,000 Thiothixene 100 Ethanol 50,000 Traylcyromine 100

9 Compound Conc. Compund Conc. tested tested (µg/ml) (µg/ml) Ethylmorphine 100 Triampterene 100 Fenfluramine 100 Triazolam 100 Fentanyl 100 α-Hydroxytriazolam 100 Flunitrazepam 100 Triflupromazine 100 Griseofuvin 100 Trimipramine 100 Hydrocodone 100 Tyramine 100 Hydromorphine 100 Urea 10,000 Hexabarbital 100 Urea 30,000 Ibuprofen 50 Urea 60,000 Ibuprofen 100 Uric Acid 100 Indomethacin 100 Verapamil 100 Isoxsuprine 100 Verapamil 500 Kanamycin 100 Verapamil 1000 MDMA 100 Naproxime 100 Mephentermine 100

pH sensitivity: Testing was conducted for BUP and Imipramine with the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device to determine the influence of sample pH on test results. Samples were tested in triplicate at a pH of 4.0, 4.5, 5.5, 6.5, 7.5, 8.5 and 9.0. No interference was observed for any pH test conditions. pH interference performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

Specific Gravity: Testing was conducted for BUP and Imipramine with the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device to determine the influence of sample specific gravity on test results. Four samples were tested, spanning a range of specific gravity from 1.002 to 1.040. All were tested in quadruplicate. No interference was observed for any specific gravity test conditions. Specific gravity interference performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

f. Assay cut-off:

Characterization of how the device performaned analytically around the claimed cutoff concentration appears in the precision section M.1.a., above.

2. Comparison studies:

a. Method comparison with predicate device:

Method comparison studies were conducted for BUP and Imipramine at four different

10 sites for the detection of BUP and two sites for the detection of Imipramine, using the QuickScreen™ Pro Multi Drug Screening Test Model 9395Z device. All tests were conducted using unaltered urine clinical samples. Accuracy performance for Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Ecstasy, Methadone, Methamphetamine, Opiates, Oxycodone, Phencyclidine, and Marijuana, was reviewed in k070098.

Method Comparison Site #1 Near Near Cutoff Cutoff Negative High Zero Below Positive (Between Positive Candidate Value 50% (between 50% below (above Device Samples cutoff cutoff cutoff and 150%) Results by by and cutoff by GC/MS GC/MS 150%) concentration) GC/MS by by GC/MS GC/MS BUP QuickScreen Positive 0 0 3 5 35 Negative 40 32 5 0 0

TCA (Imipramine) QuickScreen Positive 0 0 1 23 17 Negative 22 20 19 0 0

Discrepant results Sample Analyte Detected Subject GC/MS Device Result Result (ng/ml) 82 Buprenophine Positive 8.21 40 Buprenophine Positive 9.04 17 Buprenophine Positive 9.29 62 Imipramine Positive 995.9

11 Method Comparison POC Site 1 Near Cutoff Near Negative Cutoff High Candidate Zero Below (Between Positive Positive Device Value 50% 50% below (between (above Results Samples cutoff cutoff and cutoff 150%) cutoff and concentration) 150%) BUP QuickScreen Positive 0 0 3 5 35 Negative 40 32 5 0 0

TCA (Imipramine) QuickScreen Positive 0 0 1 23 17 Negative 22 20 19 0 0

Discrepant Results Sample Analyte Subject GC/MS Detected Device Result Result (ng/ml) 82 Buprenophine Positive 8.21 40 Buprenophine Positive 9.04 17 Buprenophine Positive 9.29 62 Imipramine Positive 995.9

Method Comparison POC Site 2 Near Cutoff Near Negative Cutoff High Candidate Zero Below (Between Positive Positive Device Value 50% 50% below (between (above Results Samples cutoff cutoff and cutoff 150%) cutoff and concentration) 150%) BUP QuickScreen Positive 0 0 3 5 35 Negative 40 32 5 0 0

12 Discrepant Results Sample Analyte Subject GC/MS Detected Device Result Result (ng/ml) 82 Buprenophine Positive 8.21 40 Buprenophine Positive 9.04 17 Buprenophine Positive 9.29

Method Comparison POC Site 3 Near Cutoff Near Negative Cutoff High Candidate Zero Below (Between Positive Positive Device Value 50% 50% below (between (above Results Samples cutoff cutoff and cutoff 150%) cutoff and concentration) 150%) BUP QuickScreen Positive 0 0 4 5 35 Negative 40 32 4 0 0

Discrepant Results Sample Analyte Subject GC/MS Detected Device Result Result (ng/ml) 52 Buprenophine Positive 6.85 82 Buprenophine Positive 8.21 40 Buprenophine Positive 9.04 17 Buprenophine Positive 9.29

b. Matrix comparison:

N/A

3. Clinical studies:

a. Clinical Sensitivity:

N/A

b. Clinical specificity:

N/A

13 c. Other clinical supportive data (when a. and b. are not applicable):

N/A

4. Clinical cut-off:

N/A

5. Expected values/Reference range:

N/A

N. Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Parts 801 and 809, as applicable.

O. Conclusion:

The submitted information in this premarket notification is complete and supports a substantial equivalence decision.